Does the noise of mechanical heart valve prostheses affect quality of life as measured by the SF-36® questionnaire?

OBJECTIVE: The closure clicks of mechanical heart valve prostheses' leaflets are quite often clearly audible. The study describes the effects of subjective valve sound perception on the patients' quality of life and analyses factors that might contribute to valve noise-related discomfort. METHODS: We included 556 patients who received a mechanical valve prosthesis and participated in the study in our institution from 1994 to 1998. All compiled the standardised questionnaire Short-Form-36 Health Survey (SF-36) and indicated their subjective disturbance grade pre- and postoperatively, then every 6 months up to 2 years. A series of factors was scanned for correlation with unpleasant noise perception. RESULTS: Two years after the operation, only 5.8% classified their valve sounds as 'quite' or 'very much' disturbing. Age <60 years and being female were statistically significant factors for persisting unease caused by valve sounds. Without one of these factors, severe disturbance chance was 1.5%. As expected, quality of life improved after surgery. Patients disturbed seriously by valve noise showed significantly lower mean life quality values on each SF-36 scale. CONCLUSION: Patients (94.2%) with mechanical heart valve replacement have no persistent complaints about the valve noise. The grade of annoyance by valve noise is paralleled by lower average quality of life. Age under 60 years or being female increases the probability of severe disturbance due to mechanical valve sounds. It remains unclear whether the disturbing noise is reason or consequence of lower quality of life.